| National Provider Identifier [NPI]: | 1851677157 |
| Last Name Of The Provider | KEOGH |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 209 COLLEGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 370831701 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 6007 |
| Number Of Medicare Beneficiaries | 2005 |
| Total Submitted Charge Amount | 280647.44 |
| Total Medicare Allowed Amount | 197779.25 |
| Total Medicare Payment Amount | 143895.16 |
| Total Medicare Standardized Payment Amount | 185782.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 6007 |
| Number Of Medicare Beneficiaries With Medical Services | 2005 |
| Total Medical Submitted Charge Amount | 280647.44 |
| Total Medical Medicare Allowed Amount | 197779.25 |
| Total Medical Medicare Payment Amount | 143895.16 |
| Total Medical Medicare Standardized Payment Amount | 185782.04 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 383 |
| Number Of Beneficiaries Age 75 to 84 | 633 |
| Number Of Beneficiaries Age Greater 84 | 805 |
| Number Of Female Beneficiaries | 1412 |
| Number Of Male Beneficiaries | 593 |
| Number Of Non Hispanic White Beneficiaries | 1624 |
| Number Of Black or African American Beneficiaries | 348 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1745 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 57 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 44 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2374 |